Organization
PROVIDENCE HEALTH & SERVICES - OREGON
Active
Parent organization
PROVIDENCE HEALTH & SERVICES - OREGON
Other names
PROVIDENCE MEDICAL GROUP SOUTH
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROVIDENCE HEALTH & SERVICES - OREGON
Authorized official
DONALD WAYNE ANDERSON JR. (ASST SECRETARY FOR ENROLLMENT)
(425) 525-5392
Entity
Organization
Contact information
Practice address
205 N PHOENIX RD, SUITE A, PHOENIX, OR 97535-9104
(541) 732-5760
(541) 732-3406
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
278307
—
OR
01
—
CG6801
RAIL ROAD MEDIARE
OR
Enumeration date
11/01/2006
Last updated
11/19/2025
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us